Information on HTLV and Zanjeer or Tatbir

For distribution by mosques to practitioners


What is HTLV?

Human T-Lymphotropic Virus or HTLV for short is an ancient virus that causes infection in humans.  It is thought that 10 million people worldwide are infected, but this is likely to be an underestimate as many parts of the world do not test for this infection routinely.


In less than 5 per 100 people, it may cause 2 serious complications: a type of blood cancer called Adult T cell leukaemia/lymphoma, or HTLV associated myelopathy in which inflammation of the nerves in the spine and elsewhere in the body can cause weakness of the legs and disability.


In London, The National Centre for Human Retrovirology at St Mary’s Hospital in Paddington looks after those who have the infection or its complications. We also have clinics in Birmingham, Manchester and York.


Why does this apply to me?

Since 2014, 10 men in England have been found to have HTLV infection.  They all practice either zanjeer or tatbir, and most do not describe other ways of acquiring the virus.


How the virus may be spread between people

HTLV can be passed on through blood transfusion of infected blood, if this has not been screened for the virus.  In the UK, since 2003, if you donate blood, your blood is routinely tested for HTLV as well as other viral infections such as HIV and hepatitis B.


It can also potentially be transmitted if blood stained equipment is in contact with broken skin, for example if sharing equipment during zanjeer or tatbir.


Other ways of spread of infection are sexually, and between a pregnant mother and her child.


How can I prevent infection during my practice?

We are examining the reasons for the association of the practice of zanjeer and tatbir with this viral infection, but in the meantime would advise the following:


Avoid contact with another person’s blood.


This means:

• Do not share equipment used in this practice with others

• Do not allow yourself to be splashed by blood from anyone else

• Wait 3 months after this practice before donating blood, or having unprotected sex

• If wounds require stitching, this should be done with sterile disposable medical equipment

• Mosques where these practices are conducted are advised to have procedures in place which support the above.  This should include decontamination procedures where blood is involved and no-touch hand washing facilities.  Blades should be cleaned with a specially made solution to remove viruses


Can I be tested for HTLV?

If you are concerned that you may have this infection, please contact us to arrange testing, in confidence.  This involves a single blood test with results usually available at 2 weeks.

It may takes up to 3 months for this infection to show in your blood, so repeat testing may be required to cover this period.  We will discuss this with you.


Contact us

Do contact us if you require further information.  Our contact details can be found on the top of his letter.  Your enquiries will be dealt with in confidence.

The National Centre for Human Retrovirology Clinic  Imperial College Healthcare NHS Trust, Ground Floor, Winston Churchill Wing, St Mary's Hospital, Praed Street, London W2 1NY